Completely overlooked in the outrage over the tragic circumstances surrounding the VA hospital system scandal are the scandals and patient abuses that go on daily in America’s thousands of other hospitals.
In recent years, I have had occasion to observe and interact with several hospitals. I want to share some of what I saw and heard, and offer several solutions:
Amazingly, hospitals are not exactly exemplars of clean environments. Factories where computer chips are made are several orders of magnitude cleaner than hospitals. Treating silicon better than humans is unacceptable. Moreover, the laws on reporting hospital infection rates are woefully deficient. In many states, they only require reporting of a handful of possible infection types. One patient I spoke to suffered six infections, including pneumonia, while hospitalized, none of which have to be reported under the state’s weak law. Since the law was enacted, the number of this state’s audits of hospital reporting requirements has declined by two-thirds due to state budget cuts. Furthermore, there is every incentive for hospitals to “cook the infection reporting books.” If you are a germ with evil intent, you want to be assigned to a hospital.
There are solutions, some of them simple and dating back to recommendations first made in the 1840s, but still not adopted and enforced in many hospitals. Thorough hand-washing and sterilization between patient interactions, for example. I personally observed numerous instances where this was ignored. Hospitals seemingly impose no punishments on doctors, nurses, health technicians and other staff who ignore these basic health procedures.
The concept of care management and managers is either non-existent or inept. Patients with multiple, life-threatening conditions enter hospitals with no treatment plan or discharge goal. They are left to fester and deteriorate. The notion of treating such “multi-morbidity” patients as a whole human being rather than condition-by-condition appears to be alien to these institutions and their physicians. Worse, chronically ill patients on long-term stays may be seen by multiple physicians who don’t communicate with each other. One patient had 16 different doctors rotating in and out during his stay.
Staff disrespect for some patients and their advocates — including close family members — is rampant. Patients who ask too many questions and try to take charge of their own healthcare, which every patient should do, risk being viewed as troublemakers and being punished for it by rough treatment when washed or moved, not to mention when fed. I watched a patient who requested pureed meals due to swallowing problems repeatedly receive hard pieces of meat and vegetables. Staff speak disparagingly of patients and family members who advocate for them behind their backs. If they complain about abuse or bad treatment, a conspiracy of silence protects the abusers, who then wreak their vengeance on the patient when no “protector” is present.
Hospitals often seem to be more focused on increasing their “market share” than on patient care. Given these practices, it is time for healthcare to become a public utility like electricity. Surely, keeping society healthy is at least as important as keeping the lights on.
Richard Hermann is a part-time Canandaigua resident and Canandaigua Academy graduate. Email him care of Messenger Post Media at